How to lower cholesterol

To lower cholesterol, particularly LDL and VLDL particles which carry cholesterol and triglycerides, you have several nutritional and pharmacological strategies:

Nutritional Approaches:

1. Reduce Carbohydrate Intake: This leads to a reduction in triglycerides, which indirectly helps lower cholesterol levels. It's essential particularly for those with insulin resistance or high carbohydrate diets 1.
2. Lower Saturated Fat: Reducing intake of saturated fats can help decrease apolipoprotein B (apoB), a marker of LDL particle concentration 1.

Pharmacological Approaches:

1. Statins: These drugs work by inhibiting cholesterol synthesis in the liver, leading to an increase in LDL receptors on liver cells, which helps remove LDL cholesterol from the blood 1.
2. PCSK9 Inhibitors: For severe cases, such as those with familial hypercholesterolemia, PCSK9 inhibitors can significantly lower cholesterol by enhancing the liver's ability to remove LDL from the blood 2.

Lifestyle Modifications:

Adopting a lifestyle that supports cardiovascular health is also crucial. This may include:

• Regular exercise
• Maintaining a healthy weight
• Avoiding tobacco smoke
• Managing stress effectively

These combined efforts in diet, medication (where necessary), and lifestyle can effectively help manage and reduce high cholesterol levels. Always consult with a healthcare provider before starting any new treatment regimen.

To simultaneously address high cholesterol and elevated alanine transaminase (ALT) levels, consider the following integrated approaches:

Nutritional Strategies:

1. Modify Your Diet:
   • Lower Intake of Saturated Fats: Reducing saturated fats can help decrease cholesterol levels.
   • Increase Fiber: Soluble fiber can reduce the absorption of cholesterol into your bloodstream.
   • Balanced Diet for Liver Health: Include foods that are beneficial to liver health, such as leafy greens, nuts, and fish rich in omega-3 fatty acids.

Exercise and Lifestyle Changes:

1. Regular Physical Activity: Exercise helps improve overall cholesterol levels and can also assist in maintaining liver health.
2. Weight Management: Maintaining a healthy weight is crucial as obesity can exacerbate issues related to both cholesterol and liver health.
3. Limit Alcohol and Avoid Toxins: Alcohol can directly impact liver function and ALT levels, so moderation is key. Additionally, avoid exposure to environmental toxins.

Pharmacological Approaches:

1. Medications:
   • Statins: Used to lower cholesterol, may also have favorable effects on liver enzymes including ALT in some cases.
   • Consider natural supplements like milk thistle: Known for supporting liver health and potentially helping in lowering ALT levels.

It's important to consult with a healthcare provider before implementing any new health strategies, especially when addressing conditions like elevated cholesterol and ALT, which may indicate underlying health issues.

To lower cholesterol and ALT levels, here's a detailed diet plan based on the insights shared in the Huberman Lab Podcast:

1. Understand Dietary Cholesterol

Dietary cholesterol doesn't significantly affect the body's cholesterol pool since most of it is excreted. Cholesterol from food is mostly esterified, which the body largely cannot absorb, and is thus excreted. This diminishes the impact of dietary cholesterol on your blood cholesterol levels 1.

2. Fats and Their Impacts

• Reduce Saturated Fat Intake: While dietary cholesterol has minimal impact, saturated fats can affect your cholesterol levels and should be consumed in moderation.
• Healthy Fats: Incorporate fats that support hormone balance and heart health, such as omega-3 fatty acids from fish, flaxseeds, and walnuts. Grass-fed butter and dairy also contain healthy trans fats, beneficial in moderate amounts.

3. Fiber-Rich Foods

Increasing your intake of soluble fiber can help reduce cholesterol absorption in your bloodstream. Include foods like:

• Oats, barley, and other whole grains
• Beans, lentils, and other legumes
• Fruits like apples, berries, and pears
• Vegetables such as carrots, brussels sprouts, and broccoli

4. Lean Proteins and Plant-Based Options

• Meat: Opt for lean cuts of meat like chicken breast and avoid processed meats.
• Plant-Based: For those on a plant-based diet, ensure adequate intake of omega fatty acids through supplements like algae or flaxseed oil to maintain healthful fat ratios.

5. Liver-Healthy Foods

• Green leafy vegetables, nuts, and fruits rich in antioxidants support liver health.
• Coffee and tea have been shown to have liver-protective effects.

6. Moderation in Alcohol

Limiting alcohol consumption is crucial as it directly impacts liver health and can raise ALT levels.

7. Regular Monitoring

Keep track of your dietary impacts on cholesterol and ALT by regular health check-ups with your physician.

This diet plan aims to balance nutrient intake to support overall cardiovascular and liver health. Always consult with a healthcare provider to tailor these recommendations to your specific health needs.

Andrew Huberman recommends monitoring your cholesterol and ALT levels starting from an early age to establish a baseline, which can inform any later changes:

• Initial Baseline: It’s suggested to get these levels checked in your late teens after undergoing puberty.
• Adult Monitoring: Subsequent checks should ideally happen in your mid-20s to compare with earlier levels. If that is not done, it is recommended around age 30.
• Ongoing Monitoring: From age 40 onward, it’s advisable to get these assessments done once a year as part of routine health checks.

This approach helps in understanding how your cholesterol and ALT levels evolve over time, providing essential data to prevent and manage possible health issues 1.